Updated July 21, 2006

Foot Care
Drugstore Do’s and Don’t’s

by J. C. Tanenbaum, D.P.M.

No matter how clean a person is, all toenails have bacteria and fungus growing on them. When an ingrown toenail digs into the skin, it pushes this bacteria into the deeper tissues of the affected toe. If the body cannot fight off the bacteria, it multiplies, and an infection results. Putting an acid on skin that is already broken simply makes the opening for bacteria larger.

If you have an ingrown toenail, see your podiatrist for treatment. If you see your toenail looking red or swollen, or you see drainage, blood, or pus on your toe, consult your podiatrist immediately. This is an emergency.

You can help to prevent ingrown toenails by learning to trim your toenails properly, wearing shoes with a wide enough toe box, and wearing socks that are not too tight.

Antiseptics
If you have had a wound or ingrown toenail treated by a podiatrist, he may recommend that you soak your foot or feet in a solution of Betadine (or generic povidine iodine) while the wound is healing. This widely used antiseptic helps prevent against infection with bacteria, fungi, and viruses. Use two capfuls of Betadine solution in a big basin of lukewarm water (never use it straight from the bottle). Soak your feet for a maximum of 20 minutes, then dry them well.

Anyone who is allergic to iodine should use Epsom salts in place of Betadine. When a foot soak is necessary, dissolve two tablespoons of Epsom salts in a big basin of lukewarm water, soak for no more than 20 minutes, and dry your feet well afterward. Soaking in Epsom salts is also a good way to reduce inflammation and pain.

Because foot soaks can dry your skin, do not routinely soak your feet every night. And do not use alcohol or hydrogen peroxide as antiseptics on your feet; they will also dry your skin.

Capsaicin products
A potentially useful drugstore purchase for people with diabetic neuropathy in their feet is capsaicin cream or ointment, which is sold under the brand names ArthriCare, Capzasin, Zostrix, and others. This topical medicine made from hot peppers can sometimes reduce pain associated with diabetic neuropathy if used regularly over the course of several weeks. It can also relieve arthritis pain in some cases.

When you first begin using capsaicin, it’s normal to experience a warm, stinging, or burning sensation where you’ve applied it. This feeling should diminish with continued use. Capsaicin can also cause stinging and burning if it gets in your eyes or mucous membranes (such as your nose or mouth), so be sure to wash your hands thoroughly after applying it to your feet.

Athlete’s foot products
Athlete’s foot is a fungal infection that usually causes itching, cracking, and redness between the toes or on the bottoms of the feet. It’s important to take care of it right away because any breaks in the skin can allow bacteria to enter and cause an infection. The good news is that as a rule, people with diabetes can safely use over-the-counter athlete’s foot creams and that all athlete’s foot creams are equally effective.

To use an athlete’s foot cream, wash your feet and dry well between your toes and on the bottoms of your feet. Rub the medicated cream in twice a day. If you see no improvement in five days, call your podiatrist. It might not be an athlete’s foot fungus after all.

When to seek professional help
You can do a lot to keep your feet healthy. In addition to protecting the skin on your feet by making smart drugstore purchases, you can extend their life by maintaining blood glucose control, following a heart-healthy diet, getting regular exercise, and wearing shoes that fit well. However, if you develop foot pain, wounds that don’t heal quickly, or any other foot problem in spite of your best efforts, don’t hesitate to call your podiatrist or another member of your diabetes care team. Foot problems that are caught early have the best chance of successful treatment.

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